PARCEL NUMBER FOR. Applications submitted that are not complete or do not include all requested forms will NOT be processed.

Transcription

1 1 YEAR PARCEL NUMBER PROPERTY OWNER/RESIDENT GERRISH TOWNSHIP APPLICATION FOR PRINCIPAL RESIDENCE POVERTY EXEMPTION & ASSET TEST The filing of this form is necessary to determine if you qualify for a Principle Residence Poverty Exemption. The questions included in this application are necessary in order to determine hardship and asset status. You are required to answer each question. If you do not answer each question and supply all requested forms, sufficient information will not be available to grant an exemption. Applications submitted that are not complete or do not include all requested forms will NOT be processed.

2 2 INSTRUCTIONS FOR A PETITIONER REQUESTING CONSIDERATION FOR A POVERTY EXEMPTION 1. Petitioner(s) must complete the application as provided by the Assessor in its entirety and return it to the Gerrish Township Assessor s office in person Monday through Friday from 9:00am to 3:00pm, or by mail to: Gerrish Township, ATTN: ASSESSOR, 2997 E. Higgins Lake Dr, Roscommon, Michigan Applications must be received before the day prior to the last day of the Board of Review. 3. Petitioner(s) will not be eligible for consideration if they do not meet the Federal Poverty Guidelines. (see table below) 4. Petitioner(s) must be the owners of property and reside at said property. 5. The petitioner(s) shall make an appointment with the Board of Review during the scheduled meeting times of the Board of Review. At that appointed time the Assessor or Board of Review may administer an oath to the petitioner(s). 6. Upon request of the Assessor or Board of Review, petitioner(s) must produce: a. A valid driver s license or other acceptable method of picture identification b. A deed, land contract or other evidence of property ownership 7. The application must include copies of the following: a. Most recent Federal Income Tax Return 1040, 1040A or 1040EZ b. Most recent State Income Tax Return MI 1040 c. Homestead Property Tax Claim 2019 FEDERAL POVERTY INCOME GUIDELINES Size of Family Unit Income Level Poverty Guidelines 1 $12,140 2 $16,460 3 $20,780 4 $25,100 5 $29,420 6 $33,740 7 $38,060 8 $42,380 For each additional person, add $4,320

3 3 IN ORDER TO BE CONSIDERED FOR ELIGIBILITY, PETITIONERS MUST COMPLETE THE FOLLOWING TASKS ON AN ANNUAL BASIS: 1. Be an owner of and occupy, as a homestead, the property for which an exemption is being requested. 2. File a claim with the Assessor, Supervisor or Board of Review, accompanied by most recent federal and state income tax returns for all persons residing in the homestead. This includes any property tax credit returns filed in the immediately preceding year or in the current year. 3. File the completed Gerrish Township Application Principle Residence Poverty Exemption Income and Asset Test form after January 1 st but before the day prior to the last day of Board of Review meetings. 4. Produce a valid driver s license or other form of picture identification if requested. 5. Produce a deed, land contract or other evidence of ownership of the property for which an exemption is being requested. 6. Meet the Federal Poverty Income Guidelines as defined and determined annually by the United States Office of Management and Budget. (see table pg. 2) 7. Asset Test: As required by P.A. 390 of 1994, all guidelines for poverty exemptions as established by the governing body of Gerrish Township shall also include an asset level test. The following assets as determined by the Gerrish Township Board shall be considered when applying for qualification for tax exemption: A. Cannot own other assets as determined by the Board of Review of over $10,000. This excludes the value of the homestead. The Board of Review shall follow the above stated policy and federal guidelines in granting or denying an exemption, unless the Board of Review and/or Supervisor determines there are substantial, compelling and documentable reasons why there should be a deviation from the policy and federal guidelines. These are to be communicated in writing to the claimant.

4 4 Gerrish Township Hardship Exemption Application I,, on this day of, 20, being the owner and resident of the property listed below, apply for tax relief under MCL 211.7u of the Michigan General Property Tax Act. The real and personal property of persons who, in the judgment of the Supervisor and Board of Review, be reason of poverty are unable to contribute toward the public charges is eligible for exemption in whole or in part from the taxation under this act. Property Code# Property Address: Property Description: Telephone: ( ) Marital Status: Single Married Divorced Widowed Age of Applicant: Age of Co-Applicant: Number of Dependents: Name (s) of Dependents Age (s) of Dependents (IF ADDITIONAL SPACE IS REQUIRED PLEASE USE THE BACK OF THIS SHEET) Have you applied for Homestead Property Tax Credit this year? Yes No If yes, how much was your Property Tax Credit? $ (Please refer to your attached MI 1040CR) Approximate lot size of property on which the Homestead is located: Does any other property in which you own adjoin the property in which you Homestead? Yes No If yes, provide lot size/acreage:

5 5 Home Value: $ Amount Owed: $ Estimated Equity: $ (In estimating equity, subtract the amount owed from the home value) Name of Mortgage Company: Monthly Mortgage Payment: $ Years of Residence at this location: Please list any additional [properties owned or currently being purchased: Property Address Name of Owner Assessed Value Total Annual Taxes Is there earned income from any of the above properties? Yes No Amount? $ Are you currently employed? Yes No Occupation: Employer: Address: Telephone: ( ) Length of Employment: Please list all persons living in this household: Name Age Relationship Place of Employment Annual Contributing Income to Household (IF ADDITIONAL SPACE IS REQUIRED PLEASE USE THE BACK OF THIS SHEET)

6 6 Income Statement You are required to provide all earned/unearned income. This includes income from salaries, Social Security, rents, pensions, IRAs, unemployment compensation, disability, government pensions, railroad pensions, workers' compensation, dividends, claims and judgments from lawsuits, alimony, child support, tax refunds, Earned Income Credit, interest income, net lottery winnings, veteran's pay, public assistance, military family allotments, private pensions, regular insurance/annuity payments, college/university scholarships/grants, monetary gifts, money received from sale of property, inheritances, or from any other sources not listed herein. Use the following spaces to disclose applicable sources. Please indicate amount in either monthly or annual amounts: Sources of Income Monthly/Annual Amount Total Monthly/Annual Income: $ Additional sources of income may be listed on the back of this page. If you are in doubt as to whether a source of income should be considered, please advise the Board of Review.

7 7 PROPERTY OWNERSHIP You are required to disclose ownership of any of the following: Motor vehicles (one per working household member}, second homes, rentals, land (other than listed herein), recreational vehicles, buildings (other than residence listed herein}, bonds, life insurance, antiques/collectibles, artwork, coin/stamp collection, special equipment, stocks, or any other asset not listed herein. Item Description Estimated/Real Value Additional properties may be listed on the back of this page. If you are in doubt as to whether a possession or property owned should be considered, please advised the Board of Review.

8 8 Accounts with Financial Institutions You are required to disclose any and all checking, savings, certificates of deposit or other monetary assets in accounts you maintain with a financial institution. Please list these accounts below. Name of Financial Institution Type of Account Balance as of this Date (IF ADDITIONAL SPACE IS REQUIRED PLEASE USE THE BACK OF THIS SHEET) Have you, within the last six months, made any large withdrawals or transferred to another individual amounts in excess of $ from any of the accounts listed above? Yes No If yes, please list these transactions below: Amount Withdrawn Date of Withdrawal Account To Whom Transferred/For What Purpose (If applicable) Loans with Financial Institutions You are required to disclose any and all loans you may have with any financial institution. Use the space below to disclose those loans. Name of Financial Institution Type of Loan Balance Owed as of this Date (IF ADDITIONAL SPACE IS REQUIRED PLEASE USE THE BACK OF THIS SHEET)

9 9 Monthly Expenses Please use the table below to report any and all of your monthly expenses. Expense Type Electricity Heating Telephone Cable/Internet Food Automobile Automobile Expenses Clothing Other: Please list Other: Please list Other: Please list Average Monthly Amount Additional Information You may use the following space below to provide any other information you feel is relevant to, or should be taken into consideration, in the Board of Reviews decision to grant hardship exemption:

10 10 Reason for Exemption Request Do not sign this form until witnessed by the Supervisor, Assessor, Board of Review Member or a Notary Public. This application shall be filed after January 1 st but prior to the last day of Board of Review. Property Address: Notice: Copies of the following must be submitted with this application: Most recent Federal Income Tax Return Form Most recent State Income Tax Return Form Homestead Property Tax Credit claim (MI-1040CR) Other identification as requested Notice: Any willful misstatements or misrepresentations made on these forms may constitute perjury, which, under law, is a felony punishable by fine or imprisonment. Statements found to be false may invalidate your application. STATE OF MICHIGAN, COUNTY OF : The undersigned, being duly sworn, deposes and says that the statements made in the foregoing application are true and that he/she has no money, income or property other than mentioned herein. Printed Name of Petitioner Signature of Petitioner Date of Signature Subscribed and sworn to me this day of, 20. Signature of Assessor, Board of Review Member, Supervisor or Notary Public FOR BOARD OF REVIEW USE ONLY Date Reviewed: day of, 20 Approved Denied Assessment reduced to: $ Supervisor Signature: Chairperson: 2 nd Member Signature: 3 rd Member Signature: